摘要
目的探讨加长型股骨近端防旋髓内钉(PFNA)治疗股骨干合并同侧股骨转子间骨折的疗效。方法采用加长型PFNA治疗30例股骨干合并同侧股骨转子间骨折患者。记录骨折愈合情况、患者下地行走情况、髋及膝关节活动度、并发症发生情况。采用Sanders评分评价髋关节功能。结果患者均获得随访,时间12~40个月。术后1个月股骨转子间骨折线开始模糊,骨折愈合时间3~6个月;术后3个月股骨干骨折端周围均骨痂丰富,包裹断端,骨折愈合时间4~9个月。术后均未发生血管损伤、脂肪栓塞、下肢深静脉血栓、骨折再移位、内固定松动等并发症。末次随访时,髋关节屈曲110°~120°、后伸5°~10°,膝关节屈曲110°~115°、伸直0°。患者均可弃拐行走,其中24例步态正常,5例轻度跛行,1例跛行明显;采用Sanders评分评价髋关节功能:优24例,良5例,差1例,优良率29/30。结论加长型PFNA治疗股骨干合并同侧股骨转子间骨折创伤小,安全性高,患者功能恢复快,疗效满意。
Objective To investigate the effect of lengthened proximal femoral nail antirotation(PFNA)in the treatment of femoral shaft fracture combined with ipsilateral intertrochanteric fracture.Methods The 30 cases of femoral shaft fractures combined with ipsilateral intertrochanteric fractures were treated with lengthened PFNA.Fracture healing,walking conditions,motion ranges of the knee and hip,postoperative complications were recorded.Hip function was evaluated by Sanders score.Results All patients were followed up for 12~40 months.The intertrochanteric fracture line began to blur at 1 month postoperation,and the fracture healing time was 3~6 months.Three months after operation,the fracture end of the femoral shaft was surrounded by abundant callus,and the fracture healing time was 4~9 months.There were no complications such as vascular injury,fat embolism,deep venous thrombosis of lower extremity,fracture re-displacement and loosening of internal fixation.At the last follow-up,hip flexion was 110°~120°and posterior extension was 5°~10°,knee flexion was 110°~115°and straightening was 0°.All patients could walk without crutches,24 of them had normal gait,5 had mild lameness,and 1 had obvious lameness.Sanders score was used to evaluate hip joint function:24 cases were excellent,5 cases were good,1 case was poor,and the excellent-good rate was 29/30.Conclusions In the treatment of femoral shaft fracture combined with ipsilateral intertrochanteric fracture,lengthened PFNA has less trauma,high safety,fast functional recovery and satisfactory efficacy.
作者
孟亚强
田云
岳晓东
MENG Ya-qiang;TIAN Yun;YUE Xiao-dong(SectionⅢ,Dept of Orthopaedics,the People′s Hospital of Zunhua City,Zunhua,Hebei 064200,China)
出处
《临床骨科杂志》
2024年第3期414-418,共5页
Journal of Clinical Orthopaedics
关键词
加长型股骨近端防旋髓内钉
股骨干骨折
同侧股骨转子间骨折
the lengthened proximal femoral nail antirotation
femoral shaft fracture
ipsilateral intertrochanteric fracture
